THIS IS A SELF EVALUATION FORM THAT WILL HELP IN ASSESSING YOUR COMPANY'S RISK EXPOSURE

If you have any questions contact our consultants at 1 (316) 683-0170

This is a general loss exposure survey or "Risk Profile." This profile represents a broad base profile and is designed only as an indication and general assessment tool of possible risk and loss exposure areas.

It is important to understand that ICC will design a "Risk Profile" specifically tailored to your organization in order to identify those area of loss exposure that maybe unique to your industry and organization.

Feel free to print and copy this form and e-mail it to ICC for a free general assessment of your risk management needs

FREE GENERAL ASSESSMENT

Risk Profile Form for General Evaluation Purpose Only!

Yes

No

1. Does the organization have a detailed brochure or general written material that describes the operations, products, or services?

Yes

No

2. Does the organization have an organizational chart?

Yes

No

3. Does the organization have a work flow chart?

Yes

No

4. Is the organization confined to one industry?

Yes

No

5. Is the organization confined to one service or product?

Yes

No

6. Does the organization own any buildings?

Yes

No

7. Does the organization lease any building to other organizations)?

Yes

No

8. Does the organization lease building from other organizations)?

Yes

No

9. Does the organization plan new construction within the next 1 to 2 years?

Yes

No

10. Are the fixed asset values established by Certified Property Appraisers?

Yes

No

11. Does the organization own any vacant land?

Yes

No

12. Do the properties have Security Alarm Systems?

Yes

No

13. Are any properties located in potential riot or civil disturbance areas?

Yes

No

14. Are any properties located in earthquake areas?

Yes

No

15. Are any properties located in flood areas?

Yes

No

16. Are any properties located in areas that have a history of damage by weather, such as tornado's or hurricanes?

Yes

No

17. Do the properties have Security Alarm Systems?

Yes

No

18. Do the properties have Fire-Sprinklers?

Yes

No

19. Do the properties have Smoke/Fire/Burglary Detection systems?

Yes

No

20. Are there any unusual fire or explosion hazards?

Yes

No

21. Is there a physical inventory taken at least once a year?

Yes

No

22. Does the organization lease machinery or other equipment (not including automobiles, light trucks, and vans)?

Yes

No

23. Is inventory stockpiled (either raw or finished)?

Yes

No

24. Is there a monthly inventory report giving amount and value?

Yes

No

25. Does the organization buy, sell or have custody of goods and/or equipment that is of extremely high value (gold, silver, drugs, etc)?

Yes

No

26. Does the organization use raw stock, inventory or equipment which requires substantial lead to order or to reproduce?

Yes

No

27. Does the organization export?

Yes

No

28. Does the organization import?

Yes

No

29. Is the organization involved in buying or selling on consignment?

Yes

No

30. Does the organization buy or sell goods which must be shipped via "waterways"?

Yes

No

31. Does the organization buy or sell goods which must be shipped via "over the road"?

Yes

No

32. Does the organization buy or sell goods which must be shipped via "air"?

Yes

No

33. Does the organization handle any material that is highly susceptible to damage (such as temperature changes, dampness, shelf life, etc)?

Yes

No

34. Is the merchandise of the organization required to be in pairs or sets?

Yes

No

35. Are most incoming shipments via "common carrier"?

Yes

No

36. Are most outgoing shipments via "common carrier"?

Yes

No

37. Are the organization's purchases FOB/COD the plant or office?

Yes

No

38. Are the organization's selling terms FOB/COD the customer?

Yes

No

39. Is the organization's trade area local?

Yes

No

40. Is the organization's trade area national?

Yes

No

41. Is the organization's trade area international?

Yes

No

42. Are any of the organization's goods or equipment located on the premise of a subcontractor, bailee, or other?

Yes

No

43. Is the business seasonal?

Yes

No

44. Does the business generate Accounts Receivable?

Yes

No

45. Does the organization have files, plans, manuscripts, drawing, or other records that if lost or destroyed, could cause serious problems?

Yes

No

46. Does the organization use EDP equipment or facilities?

Yes

No

47. Does the organization rely on long term contracts with customers?

Yes

No

48. Does the organization rely on a limited customer base?

Yes

No

49. Does the organization rely on limited suppliers?

Yes

No

50. Does the organization rely on a supplier that has limited production capability or warehousing?

Yes

No

51. Does any one account represent more than 1% of the organization's gross sales?

Yes

No

52. Does any one account represent more that 25% of the organization's gross sales?

Yes

No

53. If there is a major property loss, could the organization operate at near or close to full capacity during the repair period?

Yes

No

54. Is the organization highly regulated by Federal, State, or local authorities?

Yes

No

55. Are all locations of the organization dependent upon a central authority?

Yes

No

56. Do any of the locations, including the main location, have property, inventory, or equipment of others?

Yes

No

57. Is it regular organizations policy and procedure to use written contracts?

Yes

No

58. Does the organization operate a health station, infirmary, or hospital?

Yes

No

59. Does the organization operate a cafeteria?

Yes

No

60. Does the organization use or operate boats or aircraft, other than commercial?

Yes

No

61. Do any employees hold a valid pilot's license?

Yes

No

62. Does the organization hold meetings or conventions outside the United States?

Yes

No

63. Does the organization perform any subcontract work?

Yes

No

64. Does the organization market through direct sales using sales persons?

Yes

No

65. Is it organizational policy to have all subcontractors provide evidence of liability and Workers' Compensation Insurance?

Yes

No

66. Does the organization test or install products or equipment on the customer's premises?

Yes

No

67. Does the organization provide written warranties as to use or fitness of the products or services?

Yes

No

68. Does any operation of the organization produce pollutants or contaminates?

Yes

No

69. Does the organization lease vehicles?

Yes

No

70. Does the organization's vehicles operate outside a 50-mile radius of home base?

Yes

No

71. Does any of the organization's vehicles fall under ICC jurisdiction?

Yes

No

72. Does the organization allow any passenger's that are not employees to ride in any organization's vehicles?

Yes

No

73. Does the organization require Driver's Training or Safety Training?

Yes

No

74. Does the organization require a pre-employment physical?

Yes

No

75. Does the organization routinely conduct a background check on job applicants?

Yes

No

76. Does the organization have a Safety Committee or council that attempts to prevent work related injuries?

Yes

No

77. Does any of the organization's employees work or travel to other States as a part of their job?

Yes

No

78. Does any of the organization's employees work or travel aboard ships or navigable waters as part of their job?

Yes

No

79. Does any of the organization's employees work or travel aboard aircraft as part of their job?

Yes

No

80. Has the organization had an OSHA inspection?

Yes

No

81. Does the organization have appropriate internal systems and procedures that are in compliance with OSHA standards?

Yes

No

82. Does the organization have any outstanding OSHA citations?

Yes

No

83. Has the organization ever suffered a loss from employee dishonesty?

Yes

No

84. Does the organization accumulate more than $1,000 cash at any single location?

Yes

No

85. Does the organization require a double or countersigned check?

Yes

No

86. Does the organization require that all incoming checks be recorded and stamped immediately?

Yes

No

87. Does the organization require daily bank deposits?

Yes

No

88. Does the organization use the services of Armored Carrier Services?

Yes

No

89. Does the organization use external auditors?

Yes

No

90. Is the organization a partnership?

Yes

No

91. Is the organization an LLC?

Yes

No

92. Is the organization registered corporation other than a public traded company?

Yes

No

93. Is the organization a public traded company?

Yes

No

94. Does the organization employee trained security personal?

Yes

No

95. If the organization employees security personal are they armed?

Yes

No

96. Does the company have a need for Surety Bonds?

Yes

No

97. Does the organization provide Group Medical Programs?

Yes

No

98. Does the organization provide Group Life?

Yes

No

99. Does the organization provide Disability Income?

Yes

No

100. Does the organization provide Pension or Profit Sharing?

Yes

No

101. Is the organization unionized?

Yes

No

102. Has the organization been doing business with the same insurance broker or company for more than 5 years?

Yes

No

103. Does the organization have a formal and written Risk Management Program?

Yes

No

104. Are the organization's assets heavily depreciated?

Yes

No

105. Is the organization's quick ratio at least two to one?

Yes

No

106. Is cash flow a problem?

Yes

No

107. Is short term credit available?

Yes

No

108. Has the organization ever sustained any unusually large or unique losses, either insured or uninsured?

Yes

No

109. Has the organization ever sustained product liability safety program

Yes

No

110. Does your organization have a ERGONOMIC program under the new OSHA guidelines?

Yes |NO | 111. Does your restaurant or bar have a license to carry a gun to protect customers against terrorist acts ?